HomeMy WebLinkAboutPermit Building 1993-4-14
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DESCRIBE WORK: "l ffi()ntd 'I~()_c+-(m~ ~ --1~
NEW JL} REMODEL ADDITION _, \ DEMOLISH OTHER \ "" ~ ~
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
LOT'
OWNER:
ADDRESS:
CITY:
SPRINGFIELD
BLOCK'
~
.
JOB NUMBER-9~O 4 ?l'-/
225 Fifth Street
Springfield, Oregon 97477
TAX LOT' CJ..I40 0
SUBDIVISION: V'Y\,.ny-;"k., &'^"""
PHONE:
--Zd.t..:- J d c-:, 'Y
CONTRACTOR'S NAME ADDRESS
GENERAL: _7/VV' p.n"..Pri ~; ~~ c:",
PLUMBING: ...t1t'"\t'V'Po-AJ l k A :'N...J[h.,..,<.-t
CONST.
CONTRACTOR N ~ EXPIRES
s:... 4 ~.1. ~t>'O <sj/~}t;?::
PHONE
'7 '+7. 4oo~
MECHANICAl'
ELECTRICAL: l:LrA ;t 13 d ~ r 2, (' ~
d
OUAD AREA:
I g..LV tJ
r
~~ 4- JV1
I
cr..
N OF BLDGS:
OCCY GROUP:
. OF STORIES'
WATER HEATER:
II)~ I ~~/)
- OFFICE USE -
LAND USE:
I J c:..()
I
\/N
F~
'2:.
1fJ..~.CJ3 72.c{'@
FLOOD PLAIN:
ZONING CODE: _k.OY'-
N OF BDRMS' ~
SECONDARY HEAT:
SQUARE FOOTAGE: _, ~I...f-D...--
TO request an inspection, you must call 726-3769. This ;s a 24 hour recording. All Inspections requested before 7:00 a.m. wlll be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
sctlin~rms.
~nders~~~g lectricall
. cchanical - Prior 0 cover.
Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Undeflleor Plumbingl Mechanical
_ Prior to Insulation or dccl<ing.
o
Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - PrIor to
decking.
r-71/3anitary Sewer - Prior to filling
~ trench.
o Storm Sewer - Prior to filling
trench.
K70Water Line - Prior t:. fliiing
t.p trench.
o Rough Plumbing - Prier to
cover.
N OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - Aflm r:rcplnce approval
and installation of unit.
o
CUI~)cul & ApPloach - After
fe'fllls are erected bl!t priol to
placement of concrcic.
C]
Sjdew.1I~. & Driveway - After
excavation is cOinpl(:~e. forms
and sllb-base material in place.
D Fence - V'Jhen completed.
o Slreet Trees - When a:1 rC'Qulred
trees arc planted.
o
Final Plumbing - When all
plumbing work Is complet.e.
o Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
~Final Building - When all
required Inspections have been
approved an~~U~d~~
completed. \J,JJ~' L...J
o Other
MOBILE HOME INSPECTIONS
~IOCking and Set-Up - When all
7 blocking Is complete.
~IUmbing Connections - When
home has been connected to
water and sewer.
~cctrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home Is connected to
the servIce panel.
~nal - After al! required
L.p-i~spections are approved and
porches, skirtIng, decks, and
venting have been installed.
1
.
Lot faces ~
Lot sq. ltg, Interior I PL.
IN
Lot coverage ...:.-.- Corner Is
Topography Panhandle Iw
Total height Cul.dc.sac IE
Setbacks
HSE GAR ACC
BUILDING PERMIT
ITEM sa. FT, x $/SO. FT. VALUE
Main M J H :?,<"LCO c)
Garage qOO~
Carport J',}. )<:J~
~~
Total Value LfCO.Q.J
Building Permit Fee jLo, CO
Slate Surcharge ,ED
Total Fee (A) JW..5:?
SYSTEMS DEVELOPMENT CHARG.E.~DC.1.
(B) Cf-1Lp .,D
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
FT.
A~ r::o
Ji~CO
Water
Storm Sewer
FT.
Mobile Home
f~,OO
Plumbing Permit
LP;C)CD
~ ,:J<=)
LPlSc9.5
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
fin)
Total Permit
(D)
MISCELLANEOUS PERMITS
IDS,dJ
cjnCO
'-~ .c.Q~
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrica..-!)J5 2fJ -+-
(A, B, C, 0, and E Combined) C(1(P AD
f' .,r.
.
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
1_._
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City 01 Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fcc:
Date P<::id:'
~
\\\~
Receipt Number:
Received By:
Plans Flcviewcd By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, thai I have carefully examined
the completed applicalion and do hereby certify thai all
Information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with ttlO Ordinances of the City of Springfield, and the Laws
of the Stnle of Oregon pertaining to the work described
herein, and IIla! NO OCCUPANCY will be mado of any
structure without permission of the Building Safety Division.
I furtller certify ttlat only contractors and employees who
arc in compliance with GRS 701.055 will be used on this
project.
I further agree to ensure that all required inspections arc
requested at the proper time, that each address is readable
from the street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on Ihe sile a~ ali limes during [~:61~
Slgl1alure~~~~ _'
Oal., 1'- /J.(-1-?
VAll DATiON:
RECEIPT NUMBER 8/1 r; --( AliA
DATE PAIr> 4, f\-,0{.~
AMOUNT RE;;gflD J:.).!:fJ, P(') (Lf1,cX .J..hd ')
RECEIVED B\:.L)~_::}
-,"-".. '\,
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SPRINCFIELD
DEVELOPMENT SERVICES
PUBLIC WORKS .
METROPOLITAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726,3753
MOBILE HOME AND MANUFACTURED HOME AGREEMENT
UNITS TO BE PL,~CED IN A PARK
As required by the City of Springfield Development Code and/or the State of
Oregon, I understand and agree, as shovn by my signature on this form, that vith
the aPEF~.a.~ the attached permi~ ~or a home to be located at
c---..'ll ;-,{ ) ~L?/)1J1J{.n. ,., .th-0i;..)../ ,Springfield, Oregon, City Job Number
. [f(j~~ I viII meet or exceed the belay listed minimum setbacks.
Home Setbacks
10 feet from a pink building
20 feet from any public street
5 feet from any rear space line or interior space line
5 feet from the edge of a park street
2 feet from the interior edge of a park side"'alk
Accessory Structure Setbacks
10 feet from a park building
20 feet from any public street
5 feet from the edge of a park street
2 feet from the interior edge of a park sidenlk
3 feet from an interior space line or rear space line
I further state, by my signature belo..., that I have been provided vith the
fo11oving information:
Manufactured Home Blocking Requirements
Minimum Requirements for Permanent Steps
- Electrical Connection
~lIIA....e
~nature
;)utWv
"f- I V -'1'3
Date
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.
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,."",'" Q\).~"
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2. CONTRACTOR INST~YON Jry
Electrical Contrac~JsJ---kJ1..fO(J ~
Address85S It )~rf
City OYJM1L Phone1!r]-/~
supervisQr Licen_se Number ~'),S- .
If)./ .q--2)"
Constr Contr. Number [0.3/-!-:::</2
If) . :;YJ f1\3
Expiration Date
Expiration Date
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~ATi~-~--~~\2\-~~~---------------
RECEIPT I: ,.I _KII X
RECEIvED BY: (!J{ f)~-
B.
Services or Feeders
Installation, Alterations
or Relocation:
, . '
.' "\\,o\o~a~:i(oP" \,X)~ lit
225 FIFTH STREET ,~~;;,~.~\, "O(\\f'C~ (\"", ~CTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 v A.\ \1:'. ..........~ =~- 1/0/\..Aad..
INSPECTION REQUEST: 726-376?o.........."". J, '0'1>\,,'0.......... City Job NUlDber~L:n:2-'
OFFICE: 726-3759 \", ..eos,<;)
~~'0O'\- 3. COMPLETE FEE SCHEDULE BELOII
1. r+OCATION~F INSTALLATIOt!.n. '1/ n
a/lSn (_ (V J1.A/1~-Fra. r-J. _ A. New Residential-Single or
Multi-Family per dwelling unit.
..J..:!ttf:!>:!lJf1p)ION crt:k)O Service Included: Items Cos t
~JL,,,, n/\/Ill?:f: 1000 sq.ft. or less $ 85.00
~ r )/r~ r ( ~ Each additional 500
sq. ft or portion
Permits are n n-transferable and ex 're thereof $ 15.00
if work is t started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
d
Sum
$ 40.00
-~
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or'Feeders
Installation, Alteration or Relocation
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited.Energy/Comm
E.
5.
SUBTOTAL. OF ABOVE
5% State Surcharge
TOTAL .
200 amps or less
201 amps to 400 amps
Signature of Supervising Electrician Over 401 to 600 amps
~~L _ ~ Over 600 amps or 1000 volts
t;^'f~_ -A/~f q: .~nch Circui ts
Owners Name~~~ ,~.
AddressJ(:{O f{..g .PO, _ ,t\Lu New,. ~lte~ation or Extension Per Panel
CitY~~Ph~e/~h mB ~~~hC~~~~~~onal' $ 35.00
, Circui t or wi th Service /J
O\INEI I ALLATION or Feeder Permi t J $ 2.00 rI..
$ 40.00
$ 55.00
$ 80.00
see liB"
above
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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